Exertion Headache - Symptoms & Causes

What is an exertion headache (exercise headache)?

An exertion headache, also known as an "exercise headache," is a type of headache that occurs during or after physical exertion or strenuous activity. These headaches can range from mild to severe and are often described as a throbbing pain that typically affects both sides of the head.

Physical activities that may cause an exertion headache are high impact exercises such as running, HIIT workouts, activities with straining like weightlifting and other triggers such as sexual activity, straining during bowel movements, coughing or squeezing.

What are the types of exertion headaches?

Exertion headaches are primarily classified into two types:

• Primary exertional headache: This type of headache occurs solely during or after physical exertion and is not associated with any underlying medical condition. They are typically benign and resolve on their own within minutes to 48 hours after exercise.
• Secondary exertional headache: Secondary exertional headaches may have an underlying cause such as coronary heart disease or a structural abnormality in the brain, such as brain tumours. These headaches often require further medical evaluation and treatment.

What are the symptoms of an exertion headache? 

Symptoms of exertion headaches may include: 

• Throbbing pain on both sides of the head 
• Pain that intensifies with physical activity 
• Nausea or vomiting 
• Sensitivity to light or sound 

In some cases, exertion headaches may be accompanied by neurological symptoms such as blurred vision or difficulty speaking. 

Primary exertion headaches usually resolve on their own within minutes to a couple of days (48 hours) after exercise. 

For secondary exertion headaches, the underlying medical condition determines the headache's duration. It could resolve quickly or persist depending on the specific condition. 

When to seek medical attention? 

Medical attention should be sought if: 

• Exertion headaches are severe or persistent 
• Headaches are accompanied by neurological symptoms such as confusion, weakness, vision changes, numbness or loss of consciousness 
• There is a sudden and severe headache, particularly if it is different from previous headaches 
• Headaches are triggered by physical exertion but continue to occur even at rest (lasting over 48 hours) 

When to visit an urgent care centre? 

Urgent medical evaluation may be necessary if: 

• Exertion headaches are accompanied by a high fever, stiff neck, vision changes, numbness or signs of dehydration 
• Headaches occur after a head injury or trauma 
• There is a sudden and severe headache, described as the worst headache ever experienced 

These symptoms may indicate a more serious underlying condition that requires immediate evaluation and treatment.

What causes an exertion headache? 

The exact cause of exertion headaches is not fully understood, but they are believed to be related to the dilation of blood vessels in the brain during physical exertion.

Other factors that may contribute to exertion headaches include dehydration, changes in blood pressure, and tension in the neck and shoulder muscles.

What are the complications of an exertion headache?

While exertion headaches themselves are usually not associated with serious complications, they can significantly interfere with daily activities and quality of life.

• Frequent or severe exertion headaches can disrupt your ability to exercise, work, and participate in daily activities. 
• Headaches can make it difficult to fall asleep or stay asleep, leading to fatigue and potentially worsening the headaches. 
• The constant presence of headaches can lead to anxiety and stress, which can further worsen headaches by creating a cycle. 
• Overusing pain relievers to treat frequent exertion headaches can ironically lead to a condition called "medication overuse headaches," making headaches even worse. 

Prolonged or severe exertion headaches may also indicate an underlying medical condition that requires further evaluation and treatment.

How do you prevent an exertion headache? 

To help prevent exertion headaches, consider the following strategies: 

• Stay hydrated, drink plety of fluids before, during, and after exercise. Aim to stay hydrated throughout the day, especially on hot or humid days. 
• Warm up and cool down, to prepare your body for exercise and help your body recover. This reduces muscle tension that can contribute to headaches. 
• Gradually increase your exercise intensity and duration, to allow your body to adapt and reduces stress on your system. Listen to your body and take breaks as needed during exercise. 
• Maintain good posture during exercise, to prevent muscle strain in the neck and head, which can contribute to headaches. 
• Eat a balanced diet. Don't exercise on an empty stomach, though you should avoid sugary drinks or heavy meals right before exercise.